Application

Organization Information (to be displayed online)

Organization Name*

Address*

Street Address Address Line 2 City State ZIP Code

Main Business Phone*

Fax

Website

Email*

Main Contact

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Title

Main Business Phone*

Cell

Email*

Billing Address

Street Address Address Line 2 City State ZIP Code

Mailing Address (if different)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Additional Information

Referred By

How did you hear about us?

What is your reason for joining?

Please have someone contact me regarding

Business Resources

Community Involvement

Cost Savings Programs (Insurance, Office Supplies, Worker’s Compensation)

Economic Development

Government Relations

Networking

Training Opportunities

Other

Please check below to NOT permit the Upland Chamber of Commerce to release the following

Photo

Email

Yelp Account

Other Social Media

Membership Investment

Membership Type*

Circle of Participation (Optional)

List your key words for your business/services

Number of Full Time Employees

Number of Locations

One-Time Application Fee

Price: $50.00

Total

Credit Card Information

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Credit Card Email Address*

Enter Email Confirm Email

Application

Organization Information (to be displayed online)

Main Contact

Mailing Address (if different)

Additional Information

Membership Investment

Please select a membership type before submitting your application.

Upland Chamber of Commerce

Upland Chamber
of Commerce